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December 21, 2015 by Brighton & Hove Psychotherapy Leave a Comment

Holiday Blues?

This time of year can evoque a range of feelings in most of us. Whilst some of us may have a festive and positive outlook on Christmas and look forward to spending time with friends and family, for many it is a time filled with conflicting emotions. Some of us have difficult memories associated with Christmas and family gatherings. For me, this season was always associated with positive memories of my grandmother. After she recently passed away, Christmas became a reminder of her absence.

Going through sad and difficult times without ignoring or suppressing feelings can be a challenge. When working with my clients around grief, loss and relationship issues I tend to be curious and ask questions about what they are experiencing and really honour those feelings, after all, they are there for a reason. In the absence of an experienced professional to guide you through this process, here are some ideas to help you not only cope, but make the most out of a challenging time.

Listen to your body

This doesn’t mean act impulsively. It is more about listening for what the vulnerable part of you needs. This may be a hot bath with a good book, a warm drink by the fire, a nice home cooked meal or spending time with a supportive friend. It could also be a long run, or a dance or yoga class. Whatever self-care tool helps you feel well and connected.

Challenge Expectations

There are many ways to spend your holidays. If you rather be on your own or spend it some place else, then why not? Just because it’s tradition for many families to gather at Christmas, it doesn’t mean you have to! If you fear that saying ‘no’ to family gatherings will upset or disappoint family members, explain that you are making a different choice this year and that you hope they will be supportive of your decision.

Spend Time Reflecting

The end of the year can be a good opportunity to review and reflect on the past year. Reflections on your present life in terms of what is going well and what could be improved on is a good starting point. Are you following your dreams and aspirations? How are you contributing to causes that you care about? What are some of your wishes for the future? Where would you like to see yourself this time next year?

Make Positive Decisions

Many people come to psychotherapy to reflect on and improve their lives with the support of an impartial other. It is never too late to become more self-aware and make significant changes in the areas of your life that you are not happy with. Whether you are experiencing grief, going through relationship issues, depression, anxiety or feeling stuck in your life, an experienced counsellor or psychotherapist will explore those feelings with you in a supportive, interested and non-judgemental way.

Wishing all a relaxing holiday and a fruitful year ahead.

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December 8, 2015 by Brighton & Hove Psychotherapy Leave a Comment

The Therapy Room

Brighton and Hove Psychotherapy started after Mark and I decided it was time to get our own premises. Finding the right work environment wasn’t easy. We spent years practicing from other clinics, never quite satisfied with the therapy rooms we used. Although, arguably, good therapy work can take place almost anywhere. A warm and welcoming therapist certainly contributes a great deal towards making her/his client feel comfortable. After all, therapy is a meeting of hearts and minds, and this matters more than the walls it takes place in, right?

There is no right or wrong answer to this, except that the environment I work in matters a great deal to me. It is to do with my wellbeing and that of my clients. If I feel stressed, distracted or uncomfortable it will invariably impact on how present I can be with my clients.

Of course there is no perfect place to work in. There will always be a certain degree of intrusive noise, which sometimes can be used for some interesting and positive therapeutic explorations. However, there are certain vital qualities that I need from my environment in order to get into the frame of mind that I wish to be in to work well.

In order for me to enjoy my work and do it well I need to be open, present, attuned and ideally relaxed. To get myself in this receptive frame of mind I make sure I engage in a self-care routine which involves attending carefully to my physical and emotional wellbeing. I see the space I work in as a reflection of how well I care for myself and for others. A significant amount of my time is spent in the therapy room, thus it needs to have the sacred qualities of a welcoming home: light, air, comfort, beauty and silence. And finally, our space is gladly shared with other therapists who value themselves, their work and the space they work in as much as we do. In my opinion, it shows we care for ourselves and the people we see.

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October 8, 2015 by Brighton & Hove Psychotherapy 1 Comment

Working with The Pyramid of Change

In our last blog, entitled ‘The Pyramid of Change’, we introduced the concept (and paradox) that in order to achieve results (change) the locus of attention needs to begin not with change but with the felt sense in the body. How can we facilitate this?

Counsellors and psychotherapists are taught to ask one particular question, in many different guises. It goes kind of like this: ‘And how do you feel about that?’. But, this question is based on a very unrealistic and dangerous assumption: that the client can feel, knows what a feeling really is, and then how to distinguish between feelings.

The ability to feel, requires an attunement with our bodies. The development of a moment to moment sensitivity to our physiology – the orchestra playing in our body – that brings forth our emotions, and enables us to define our feelings.

Most people presenting for counselling or psychotherapy have experienced some sort of relational trauma in childhood, the severity of which correlates to their pathology, or current relationship to self and others. In attachment theory language, they are insecurely attached. And remaining in attachment theory language, the role of therapy is to change that attachment style to one of secure attachment. We re-parent our clients. At least, that’s the idea.

When we assume that a client knows what they are feeling, we assume that there was enough attunement – bodily, psychically, emotionally and mentally – from their primary carer, for this developmental process to have been completed. Sadly, this is very unlikely to have been the case.

The role of culture and gender

In the Western world, ‘feeling’ is not seen as helpful. In fact, most corporate and political structures reward a lack of feeling. Thought is prized above all else, yet few of us stop to think about why we are thinking a certain way.

Add into this generations of subscribing culturally to a patriarchal model that dictates that ‘boys should be strong’ and you have a recipe for disaster when it comes to people working out how they feel. Most men have profound trouble defining a feeling and when they can, the feelings tend to be somewhere in the region of ‘OK’ or ‘shit’, with little in between. Women may generally be slightly better at this than men, but their sensitivity to their emotional state remains curtailed by the mind-body split and social conditioning.

If, as is increasingly being evidenced through research in the fields of neuroscience and neuroendocrinology, results (change) are driven by an attunement to our physiology ,as the first step, and then the regulation of affect (physiology and emotions) through directly influencing our physiology, as the second step, I would suggest that as counsellors and psychotherapists our job is two-fold.

Firstly we are responsible for using our own physiology, emotions, psyche and mind – to help clients understand what they may be sensing in their bodies, how these sensations are travelling (emotions), how clusters of emotions comprise feeling states, how these feeling states influence their thoughts, how their thoughts influence their behaviour and how all of this ultimately contributes to how they experience themselves and others in the world (results).

The second step is to help clients tolerate their uncomfortable feeling states and whilst remaining connected to the here-and-now. This is in part and initially achieved through the relationship in the therapeutic dyad, and subsequently in part through helping clients’ access tools (internal and external) that enable them to regulate their own emotional state (which we have blogged about before).

It is these two steps, that we believe, comprise results driven Functional Psychotherapy and should lie at the core of any treatment plan. To quote Dr Allan Shore, psychotherapy is ‘an affect-communicating and affect-regulating cure’.

And, of course, there is a process preceding steps one and two that clinicians can come to overlook: if we want to be able to offer this to our clients, we need to be able to do it for ourselves. It can’t be learnt from a book, or in expensive training courses. It is the cultivation and development of our own felt sense and emotional landscape. Otherwise we are offering our clients mere insights, at best, which can only lead to short-term behaviour changes. And behaviour changes, as we now know, lead to failure, as long-term change starts in the body and not in the behaviour.

So, to end, I would suggest that we all need to reconsider our intentions in asking our stock question of ‘so how do you feel’ and follow it up with variations on the following:

‘And how do you know you are feeling that?’; ‘What is happening in your body that tells you that?’; Notice that and hang out with it, how is that?’; and ‘What happens next?’.

Image Credit: Brighton and Hove Psychotherapy Copyright

For more information on the Pyramid of Change, click here to download our guide.

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October 1, 2015 by Brighton & Hove Psychotherapy 2 Comments

The Pyramid of Change in Psychotherapy

Counselling and psychotherapy is about change. Whether that is a fundamental change in how we experience ourselves in the world, or in working through a difficult emotion and changing how we are feeling. Everybody who enters into a process of therapy is seeking change of some kind.

There are a myriad of books written about applied psychology, counselling and psychotherapy. These books use different psychological methods (theories) to explain people’s problems and how change can happen. However, whilst these thoughts, theories and models all talk about the process differently, what they all have in common is helping the client to change.

Whilst the process of change is difficult, understanding the fundamentals of what drives change and how we change can be really useful. At Brighton and Hove Psychotherapy we call this The Pyramid of Change.

What is the Pyramid of Change?

Humans are embodied beings (as are all living creatures). We reside in our bodies and are constantly receiving data from our bodies. The problem is that most of us have either never learnt to listen to our bodies, or have ‘tuned out’ the body’s messages. Why does this matter? Because all of our emotions, leading to feelings, leading to thoughts, leading to behaviours and, finally, leading to change or results, originate in the body – our physiology.

The base of the pyramid refers to ‘Physiology’ and can best be described the orchestra the body plays moment to moment. It comprises all our biological and emotional systems. For example, we all take for granted we are breathing and generally pay little attention to this process. However, through bringing our attention to our breath we can both get valuable feedback – am I breathing deeply or shallowly?; is my breathing fast or slow? – and we can then influence our breath. The same goes for our heartbeat – with some concentration we can become aware of our heart beat and feel it beating in our bodies and calm our heartbeat down (or speed it up).

Our physiology – the data stream from our body – is both influenced by our internal and external environment. For example, we may feel some discomfort in our legs after sitting for a long time informing us that we need to move position (internal) and our heartbeat will likely speed up if we hear a loud explosion or noise nearby (external).

This orchestra of the body, whether an itch on the top of our head, to a sensation in our big toe, provides us with a constant stream of data. And it is this data that comprises our emotions.

Emotions are data streams ‘in-motion’: the data being fed from all the systems in our bodies dictates what emotions we are experiencing. Emotions are synonymous with pieces of music – data from our body – that have a unique composition. They are felt states of arousal. And there are a lot of them. 34,000 have been identified!

Feelings, the next level up the pyramid, are the labels we apply to emotions. It is common in our language to say ‘I am angry’ or ‘I feel angry’. A more accurate expression would be ‘I am doing anger in my body’.

Feelings and thoughts are intricately linked. Through neuroscience we now know that whilst some thoughts can impact on our emotional state, generally the process works the other way around – feelings dictate our thoughts. The problem lies in the fact that as most of us are so cut off from our bodies, and thus cut off from the felt state in our bodies, we don’t know from one moment to the next what we are actually feeling and so go on the thoughts that seem to randomly appear in our minds.

Hopefully by now it may be clear that rather than being random, our thoughts are often driven by of feelings which are ultimately driven by our physiology. However, very few of us stop to ‘think about what we are thinking’ – to ask ourselves ‘how is my felt sense (physiology in-motion leading to feelings) influencing how I am thinking right now. If we did, we would discover the answer is in fact, quite a lot!

Our behaviour is driven by our thoughts. If we think we are enjoying something, we move towards it and vice versa if we are fearing something. There are plenty of studies that the human thought process can be influenced without our awareness leading to changes in behaviour. And these changes are driven by our physiology changing in response to the stimulus.

As a society we tend to focus on behaviour changes to change results. Examples are numerous from how children are schooled, how the judicial system functions through to how we try and create different results in our own lives through pure behaviour focused strategies that tend to fail. A good example most of us can relate to are New Year’s resolutions.

Change therefore, needs to be driven through an attunement with our physiology – by our psychotherapists and ourselves.

Our next blog focuses on the clinical implications of therapy in the context of The Pyramid of Change.

Image Credit: Brighton and Hove Psychotherapy Copyright

For more information on the Pyramid of Change, click here to download our guide.

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September 14, 2015 by Brighton & Hove Psychotherapy Leave a Comment

Self Care 101 for Therapists

Counsellors and psychotherapists can be very good at suggesting to clients to start to develop compassion for themselves, stop destructive behaviours and to learn to self-care. This is, after all, part of their job. However, how high a priority is their own self-care? How can clients assess whether their therapist is able to appropriately self-care and lastly, how good are therapists at really addressing their physical, mental and spiritual needs: the holy trinity of self-care?

I my work as a psychotherapist, I am often aware of the blindness of fellow clinicians when it comes to self-care. Given the nature of their role in working with unconscious process and being emotionally available to clients (attunement), this is a very real risk to their clients’ wellbeing and scope for healing, irrespective of the effect this may have on their own long-term health. Just like children swim in their parents’ unconscious like fish swim in the sea, so do our clients in relation to us.

So serious an issue is this that the BACP, in their BACP Ethical Framework state: ‘Practitioners have a responsibility to themselves to ensure that their work does not become detrimental to their health or well-being by ensuring that the way that they undertake their work is as safe as possible and that they seek appropriate professional support and services as the need arises’.

What is less clear is what self-care constitutes for counsellors and psychotherapists and what, in practice, they should be doing. In my own training journey over a period of 5 years across two countries and three different institutions, the only reference of ‘self-care’ I ever encountered was that we, as clinicians, undertake sufficient ongoing training and clinical supervision. Indeed, this is currently the only evidence of self-care requested by the two main professional bodies in the UK: the BACP and the UKCP.

In his 1995 book ‘Compassion Fatigue, Charles Figley suggested that there is a very specific risk for those of us engaged with this profession:‘…there is a cost to caring…the most effective therapists are most vulnerable to this contagion effect…those who have enormous capacity for feeling and expressing empathy tend to be more at risk of compassion stress…’ (p.1). He goes on to interchange the term ‘compassion fatigue’ with ‘secondary traumatic stress’, further highlighting the emotional effects of working with traumatised clients. With this in mind, I would suggest that a comprehensive, holistic and ongoing approach to self-care is not only essential for wellbeing, but a moral imperative.

Psychotherapy is rapidly evolving into an approach that incorporates not only the mind, but the body and the spirit directly through the relationship between therapist and client. Therapists who fail to address their self-care needs may find themselves left behind as they are unable to authentically embody and facilitate whole life change in their clients, remaining stuck on providing mere cognitive insight – which does not lead to any change.

So what do we recommend as areas of self-care for therapists?

Keep doing your own work

If therapy is a process of healing loss and trauma and establishing and nurturing a relationship with ourselves, then the process never ends. Being in ongoing therapy as a therapist is, after good supervision, a fundamental method of self-caring and letting go of any secondary trauma we have collected during our client work.

Be in your body

Being an effective psychotherapist does not mean that we need to be hitting the gym daily or running marathons. However, each of us has a body and being a person who is present to their process and the world requires being in one’s body.

Any activity that enables us to feel embodied – in our bodies and present with the here-and-now is vital. This can be a walk in nature, a swim, yoga or gardening.

Develop a daily practice

Mindfulness is all the rage at present, but for a good reason: our minds have become poor at maintaining an inner calm as society increasingly caters to our every whim – the age of instant gratification.

Mindfulness and meditation open the doors to inner peace in a physiological sense through bringing our awareness to our sensing and bodies and through cultivating an ability to be present with this felt sense.

Research is also increasingly showing that psychotherapy and a daily practice, work in conjunction with each other to help clients regulate their emotions and establish a relationship with themselves. So, if we advocate it, we should do it!

Take regular breaks

This may be obvious but self-care is not just something to focus on at the weekend or on holiday. Taking regular breaks throughout the day as a constant focus on looking after ourselves is as essential as planning in longer breaks.

Psychotherapists I have come to respect as clinicians, seem also to be those who have become very good at self-caring and in ensuring that they take a break at least every three months. And if money is an issue, a break can just as well be a ‘staycation’ and a trip to Barbados – just avoid dealing with email enquiries!

Find meaning outside of work

Most counsellors and psychotherapists who work in this profession do so as it gives them a profound sense of meaning and purpose. However, it cannot and should not be their only, or even main, purpose in life. And nor should it be a substitute for having and enjoying healthy relationships and experiences outside of our client sessions.

Therapy is should never be a narcissistic endeavour on the part of the counsellor or psychotherapist; we are not there to facilitate a process in our clients simply because of our own inability to facilitate this very process for ourselves. This is unethical. It is our duty to self-care and our clients have a right to question for themselves whether we are embodying what we preach.

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July 28, 2015 by Brighton & Hove Psychotherapy 1 Comment

Trauma

My heart is racing and I feel constantly under threat,
even though there is nothing to fear.

Emotionally it is like I’m in a war zone, ready to defend or attack,
even though it’s peaceful here.

I look over my shoulder,
tense up with certain sounds.
I’m scared for my life
and for the life of those whom I love,
even though it’s safe here.

I want to be able to forget and relax,
I wish I could enjoy life more.
I long for my mind to be quieter
and to engage with the small pleasures in life.

I want to stay in my body
and not leave it behind

I wish I could think clearly,
love more,
fear less,
smile often,
play lots,
breathe…

I dream of the day when I will be free.

This poem is dedicated to all of those who live with the effects of past trauma everyday.

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July 13, 2015 by Brighton & Hove Psychotherapy 7 Comments

What is the purpose of counselling or psychotherapy?

Were you to ask a group of clinicians (counsellors or psychotherapists) to define the purpose of therapy , you will likely get a set of quite different answers based in a large part on the lens (modality) through which each clinician views mental health and their approach. One would hope to find some degree of similarity between them, but ultimately, there seems to be no agreed upon objective apart from somehow ‘helping’ the client to feel better. I see this as profoundly problematic.

It is a question that in my view is enormously ethical as surely, as psychotherapists, we have a duty to firstly do no harm, and secondly, to be of service to our patients? If so, then what is the purpose of psychotherapy?

As psychotherapists, I would suggest we have to walk a line between holding a clinical diagnosis and being present with the patient’s experience; too much of a shift in either direction, and the ability to hold both the individual and their underlying psychic structure becomes lost. We therefore need to have a clinical understanding of what is happening in the mind of the patient and to be able to work with this, whilst also remaining present with the patient’s moment-to-moment experience in the room – no mean feat!

Like any other clinician, I have my own lens – broadly psychoanalytic – through which I think about a patient’s mental state. I am trained to work with the unconscious and thus believe in how past experiences and relational patterns repeat in the client’s experience of their lived experience in the present. Secondly, I believe that what has been damaged in relationship, can only be healed in relationship.

I am also heavily influenced by object relations theory, meaning the study of how a patient has internalised the relationship(s) with their primary caregiver(s) and then how this manifests in their relationship to themselves and their significant others. However, not all clinicians believe in the unconscious (notably person-centred therapists) and not all work relationally.

Too much time and energy is taken up with the ongoing debate and argument about which approach and method is best. Approaches to understanding a patient’s internal world are like languages – they often say something similar and in some cases can be literally translated but nonetheless, they also contain with them ‘cultural’ expressions and understandings that simply cannot be translated. And where these cultural expressions form the bedrock of an approach, they can end up diverging significantly. However, at their core they all seek to help patients make sense of their experience and aim to ‘help’, so where is the commonality?

I believe that perhaps it can at least in part be encapsulated by the following bullet points:

To assist patients in becoming aware of their emotional state, so they can know when they are experiencing emotions;
To assist patients in learning to express their emotions safely (to themselves and to others) using language (feelings), so they can become aware of and protect their personal boundaries;
To work with patients in separating the past from the present on an emotional level, so that they can experience their emotional response to the world based on their present needs, rather than on past trauma being re-triggered and replayed;
To teach patients to address their present and genuine needs – which will involve in turn them feeling satisfaction; frustration; and negotiating – as opposed to repressing – their needs to protect an attachment.

Whilst I technically work within the realm of mental health, very little of my work is genuinely about any sort of psychiatric disorder; most of my patients are stuck in some way and have no learnt through adequate parenting how to feel, consider, contain and express their emotions in a healthy way.

Successful talking therapy depends on the patient-therapist relationship. Relational trauma and damage occurred in their relationship(s) in early life and so it is only through relationship that this can be worked through. The function of the relationship with our primary caregiver is firstly, once we step beyond the obvious physical needs, one in which we learn how to feel and navigate our emotions, and secondly, one in which we become aware of the emotions and mind of another – relationship.

Counseling and Therapy Help People Feel and Understand Themselves

Unless people are able to navigate their emotions, establishing any kind of genuine relationship that is stable and fulfilling becomes nigh on impossible. The role of the therapist and thus therapy is, therefore, to help the patient become aware of what they are feeling, help them to differentiate between the past and the present (on an emotional/affect level) and to pendulate through their states of arousal without becoming overwhelmed.

Creating a Relationship the Patient Never Had

So perhaps ultimately the purpose of cpsychotherapy does go back to creating a relationship with the patient that they never had, so that through the therapeutic relationship they can learn to regulate their emotions in healthy ways. From the therapist’s perspective, this is contingent on a careful and precise attunement to the patient’s emotional and nervous system, teaching them to know themselves first, so that it then becomes safe and thus possible to know themselves and the other in the capacity of a relationship.

Image credit: Sam Jahara

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July 6, 2015 by Brighton & Hove Psychotherapy Leave a Comment

Making the Most of Therapy

Starting a process of counselling or psychotherapy can be daunting. It is also a significant commitment. And just as we are paradoxical in other areas of our lives, we are paradoxical when it comes to therapy; part of us wants to embrace change and another part doesn’t. So how can you get the most from your therapy? Here are five top tips which are less about doing and more about your relationship with yourself and your therapist, which will help you in your therapeutic journey:

Be Curious

In my view, a spirit of curiosity and openness to exploration on the part of client and therapist allows for a deeper and more interesting process. The reason I love what I do is because I never cease to be amazed by the richness of the human experience. Therapy facilitates self-knowledge. Therefore, there is no better way of knowing oneself other than being curious about your own experience.

Engage Honestly

This includes being honest about not being honest. Therapy can only benefit you if you are fully honest with yourself and your therapist. Being honest does not mean a full detailed confession of what is going on in your life. It is more about not leaving out vital material, which is holding you back in life. It’s totally okay to say to your therapist: “This is difficult for me to talk about, but I think it’s important that I do.”

Build a Meaningful Relationship with Your Therapist

Research shows that the success of therapy is linked with the quality of the therapeutic relationship. It is important that you feel safe and are able to trust your therapist. This is not to say that things won’t feel difficult or wobbly at times. However, basic trust between therapist and client is an important component of the work of therapy. It may take sometime to build trust in the relationship, and when mistrust arises it is important that you feel able to discuss this with your therapist.

Pay More Attention

One of the many benefits of therapy is an increased level of self-awareness. You will gain more from your weekly or twice weekly sessions by paying more attention to your thoughts, feelings and interactions in and outside of therapy. This includes observing familiar patterns of behaviour and negative self-talk.

Prioritise Your Sessions

You have come to therapy to feel better and get better. However, your wellbeing and recovery can only take place when you value it and prioritize it. Come to your sessions on time and attend weekly, no matter how resistant you are feeling. It’s okay to say to your therapist: “I really didn’t feel like coming here today…”

Lastly, if you are in any doubt as to the value of therapy, then check out this blog which will help you quantify how valuable therapy can be.

Image credit: Mark Vahrmeyer

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June 29, 2015 by Brighton & Hove Psychotherapy Leave a Comment

Make me happy…

When clients first present for counselling or psychotherapy, I generally always ask them what they would like to get from our work; how will they know that what we have done has been worthwhile for them? The answer to this can give the work important clinical perspective, but can also provide an insight into the client’s way of seeing the world, particularly when the answer is ‘I want to be happy’.

Nowadays, there is a lot of pressure on all of us to be happy. We are told that buying certain products and experiences will make us happier; the government (ours and others) attempt to measure happiness and rank us against other more and less ‘happy’ countries; and all our social media friends seem to post selfie after selfie showing how happy they are in their lives.

Recently I came across an article by Gruber, Mauss and Tamir entitled ‘The Dark Side of Happiness? How, When and Why Happiness is Not Always Good’ which poses four philosophical questions about happiness:

Is there a wrong degree of happiness?

The researchers focus was on whether an over emphasis on happiness can come at the cost of other emotions which they labelled ‘negative’ such as anger or sadness. Such a focus may then lead to suppression of other authentic emotional states and behaviour associated with chasing happiness (dopamine chase) such as risk taking.

Is there a wrong time for happiness?

The researchers suggested that our emotional state should reflect the circumstances and thus that affect regulation is suited to the environment. Their suggestion was that when we are happy we tend to seek out social bonds and increase our resources which could be inappropriate or downright dangerous in some situations such as when we are under threat and our energy should be directed to protecting ourselves.

Are there wrong ways to pursue happiness?

It seems to be the zeitgeist to pursue happiness whenever and wherever but there is some evidence that the focus on achieving happiness can get in the way of actually obtaining it. Furthermore the researchers concluded that an unhealthy focus on happiness can lower our resilience in dealing with disappointment.

Are there wrong types of happiness?

With this question the focus seemed to be on an authentic expression of happiness versus hubris and pride.

From the perspective of therapy and I would argue an emotional healthy way of being in the world, happiness is no more important than any other authentic emotional state. Of course, humans, like all animals, are primed to avoid pain and discomfort and maximise pleasure, However, this is perhaps not the same as trying to be constantly happy.

A healthy emotional system depends, quite simply, on being able to do two things at once: feel whatever emotion we are feeling in response to a situation (and that that emotion is broadly one that others can comprehend – empathy) and secondly, that the emotion we feel can be felt without us becoming overwhelmed.

How is this achieved? Internally this is achieved by us learning to feel all our emotions and connect our emotional experience to our mind. If we feel without being able to think and process, we become overwhelmed and reactive. And if all we do is think, we fail to feel. Externally, I would suggest that we can be fully in the world and feeling our emotions by making our lives meaningful, which is not the same as happy (though it would be nice to feel happiness at times).

So, whilst I broadly agree with the research findings in an academic sense, I wonder whether the real world focus should be on meaning making and creating contentment, together with the ability to experience the full range of human emotions without becoming overwhelmed.

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May 29, 2015 by Brighton & Hove Psychotherapy Leave a Comment

5 Reasons to Join a Therapy Group

“The person is comprehensible only within this tapestry of relationships, past and present” (Mitchell, 1988).

Despite the great therapeutic benefits of psychotherapy groups, unfortunately they are sparsely offered within the therapeutic community. This may have something to do with the current focus on individual therapy, lack of will (or skill) of therapists in leading groups, or even a product of an increasingly individualistic society. Therapy groups, when well led and put together, are filled with potential for personal growth and development. Of course therapy groups aren’t for everyone and individual therapy may be a better option for many. But if you are curious about groups, here are some very good reasons to become part of one:

It is an evidence-based form of psychotherapy

A vast body of outcome research (Yalom, 2005) has showed that group therapy is a highly effective form of psychotherapy and that it is at least equal to individual therapy in its power to provide significant benefit to clients.

Universality Lessens Isolation

Many individuals enter therapy with the unsettling thought that they are alone with their problems. To some degree this is true in the uniqueness of the constellation of issues which we all experience. However, when this sense of uniqueness is heightened, it can severely affect our relationships and isolate ourselves from others. In a therapy group, the disconfirmation of this fact through listening to other’s experiences can be a powerful source of relief. Some go as far as describing this experience as “feeling welcome into the human race”.

Working Through Unfinished Business

Most individuals seeking psychotherapy have experienced emotional difficulties to varying degrees in their first and most important group: their family of origin. The group offers the opportunity for understanding familiar patterns of interactions, and experimenting with new interpersonal behaviours in a safe and supportive environment.

Interpersonal Learning

There is convincing data which shows that human beings have always lived in groups that have been characterised by intense and persistent relationships amongst members and that the need to belong is a powerful, fundamental, and universal motivation (Yalom, 2005). Many of the challenges we experience in life are directly linked with difficulties in interpersonal relating. Groups can be supportive when it comes to lessening their members’ interpersonal struggles and in increasing their ability to form rewarding relationships.

Group Cohesiveness and Sense of Belonging

Many of us have lacked in ongoing experiences of peer acceptance in childhood, therefore validation by other group members can be a new and vital experience. The intimacy created in a group is a positive counterforce to a technologically driven culture, which increasingly dehumanises relationships. Therefore, there is a greater need than ever for group belonging and group identity.

Group Psychotherapy is offered at our Hove practice. For more information, please visit our group psychotherapy page.

This blog is written by UKCP Registered Psychotherapist Sam Jahara

Image credit: Sam Jahara

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May 26, 2015 by Brighton & Hove Psychotherapy Leave a Comment

The Value of Therapy Quantified

We live in an age where increasingly our value of anything comes down to money. Even environmentalists are needing to show the value of ecosystems and specific species of animals, in order to put forward a robust case for conservation. Little wonder then that the question of the value of counselling and psychotherapy in monetary terms raises its head from NHS commissioners through to money-conscious clients.

Until recently this has not been a simple question to answer. Therapists know that therapy is valuable – whether directed towards specific behavioural change or as a process of self-enquiry and self-reflection. However, quantifying the benefits in monetary terms has not always been that simple. Sure, if a compulsive gambler stops gambling, the financial pay-off can be immediately visible, however, I would suggest that the benefits (financial and emotional) go much further than the savings made from avoiding the betting shop and breaking an addiction.

Well, research undertaken at the University of Warwick seems to be getting closer to quantifying the value of therapy, at least versus receiving direct financial reward and it turns out that psychological therapy is 32 times more valuable than money in increasing our well-being!

We all need money to meet our basic needs such as food, shelter, water etc. in order to survive – cue Maslow’s Hierarchy of Needs. However, once our more basic needs have been met, additional money seems to have little to no correlation to happiness and well-being. The research paper entitled ‘Money and Mental Health: The Cost of Alleviating Psychological Distress with Monetary Compensation versus Psychological Therapy’ suggests that in the developed world, despite huge economic gains and a political focus on economic growth during the past 50 years, national happiness has not increased. In fact, quite the opposite: mental health seems to be deteriorating across the globe.

Through comparing 1,000’s of data sets of participants reporting on their happiness, the researchers looked into how happiness changed due to therapy compared to sudden increases in income such as through lottery wins or a jump in salary. The results showed that a four-month course of therapy, equating to an investment of £800, led to an overall increase in well-being equivalent to a pay rise or windfall of £25,000. In purely financial terms, therapy could be 32 times more effective at improving well-being pound-per-pound than money.

Interestingly, an additional point raised by the paper discusses how ineffective financial compensation is when dealing with trauma – e.g. the court system – and that psychological therapy could be a significantly more effective way of supporting people in overcoming their traumas.

So there we have it. Therapy works. Us therapists always knew this but now we are starting to get a grasp of how much it works in financial terms.

Link to research paper: http://www2.warwick.ac.uk/alumni/services/eportfolios/psrfbb/boycewood_hep_website_copy.pdf

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Transactional analysis (TA)

What is transactional analysis (TA)?

Transactional analysis is now a widely used and well recognised form of psychotherapy. Originally conceived by Eric Berne in the 1950s it involves a range of conceptual and practical processes and tools to encourage growth and change.

TA is used to facilitate a better understanding of individuals, relationships and communication. TA as a theory of personality, communication and child development is applied as a tool in working with psychological issues, ranging from everyday living problems to severe mental health difficulties.

In recent years many new trends in transactional analysis therapy have emerged producing exciting and effective approaches. Some of our Transactional analysis psychotherapists have trained at Metanoia Institute, where many of the recent developments in this field originated from. One of the most significant developments has been termed relational transactional analysis.

How did TA psychotherapy start?

Transactional analysis was presented by Eric Berne as a way to build on the philosophical constructs used by Sigmund Freud. This involved using observable data gained by analysing a client’s social transactions, as opposed to just their personalities.

By mapping interpersonal relationships between what he termed as ‘ego states’ (parent, adult and child state), and investigating the way individuals currently in each state communicated with each other (known as transactions), Berne was able to recognise ‘games’ within them. He saw patterns recurring during these transactions which provided deeper insight into the individuals.

Berne’s work to bring transactional analysis to the mainstream therapy world took place largely during the 1950s and the 1960s, with several notable articles published by Berne, and a book entitled Transactional Analysis in Psychotherapy: Structures and Dynamics of Organizations and Groups published in 1963.

How is TA therapy different?

As opposed to solely diving into an individual’s past to gain insight, transactional analysis also focuses on the way a person currently interacts with others around them. This encourages self-awareness when it comes to conditioned responses without the use of additional techniques.

How is TA psychotherapy used in counselling?

Transactional analysis in counselling works as talking therapy, with a collaborative approach between the therapist and the individual. Once the goals of therapy have been established, initially sessions will work to establish the current ego state of the client. Then, they’ll work with them in an analysis of their communication with others to discover their unconscious ‘life script’.

Transactional Analysis

Benefits of relational transactional analysis therapy

Improved communication style

Because TA focuses on interactions with others, your communication in all areas of your life can stand to be improved by transactional analysis. This could be in the workplace, parenting your children, talking to your partner, or even just talking to strangers.

Greater self-awareness

TA seeks to remove your blindfold when it comes to how you interact with people around you, so you’ll have a better insight into how you manage your emotions, and your behaviour. You’ll get to recognise thought patterns in response to different situations, so you know how best to take a more objective view of things.

Strengthened conflict resolution

That improved communication style is going to come in handy when things get heated, by working to make your responses calm and effective in resolving the problem as opposed to inflaming the situation further.

Improved relationships

By being better at communicating and by having greater self-awareness, you’ll find that your relationships with others improve, as you’ll be able to better recognise where their communication is coming from, and how you can overcome your conditioned responses. This encourages trust, empathy and understanding between you and those around you – all good building blocks for healthy, fulfilling relationships.

Transactional analysis psychotherapy is offered by Sam Jahara, Gerry Gilmartin and Chris Horton.

What happens during transactional analysis?

Taking on the journey of transactional analysis therapy can be daunting. But during your sessions, we explore patterns of communication and behaviour to improve relationships and focus on understanding ego states and their impact.

Your first session

Your first session provides an opportunity for you and your therapist to get to know each other and determine if it’s the right fit. You may experience a mix of relief and anxiety as you enter into this journey, and this is normal. Your role during the first meeting is to gauge whether you feel comfortable enough to share your personal inner world with the therapist and ask as many questions as you feel necessary to make your decision. It’s important to remember that there is no rush for making your decision, and you should take time to understand how you feel following the meeting.

Confidentiality in transactional analysis therapy

Confidentiality is crucial in therapy as it ensures everything that is discussed in your sessions stays between you and your therapist. However, there are rare instances where confidentiality may be broken if you are deemed to be a risk to yourself or others.

The frame

The frame in therapy refers to the physical and contractual boundaries that create a conductive therapeutic environment. Each clinician may have their own unique approach to the frame, but its purpose remains consistent – to safeguard both you and the therapeutic process.
The frame may include various aspects including the time and location of sessions, confidentiality, fees, and the consistent manner in which your therapist interacts with you.

Ongoing sessions

Most people who come to transactional analysis therapy either come for an agreed number of sessions or will enter into an open-ended contract with their therapist. However, once people get into a rhythm with therapy and start to see the benefits that translate into your everyday life, it’s not uncommon for them to want to continue with their therapy.

If you are unsure of the type of therapy you need, you can search for a therapist to suite you.

Our TA therapists

Based across Brighton, Hove and Lewes, our transactional therapists use their wealth of experience to fully understand the needs and goals of their clients before applying transactional analysis techniques to gain insight into how they interact with those around them.

The entire Brighton and Hove Psychotherapy team are committed to bringing a wide range of therapy styles to our clients, and our transactional analysis therapists are no exception.

Why choose Brighton and Hove Psychotherapy?

Choosing Brighton and Hove Psychotherapy is a really important step in your journey to better understanding yourself, and overcoming the challenges that life throws at you. We have assembled a truly remarkable team of highly trained psychotherapists, who have the experience and knowledge to apply a variety of techniques and styles of therapy to the needs of many client groups. We do this from well-appointed, convenient locations in Hove and Lewes, as well as offering online sessions to enable you to make the time for yourself that you need.

For more information, check out our Transactional Analysis Psychotherapy PDF guide.

All the content on this page has been reviewed and vetted by Sam Jahara Transactional Analysis Psychotherapist, Supervisor and Co-Founder of Brighton and Hove Psychotherapy. For any questions or more information about the subjects discussed on this page please contact us.

Frequently Asked Questions

Can couples do transactional analysis?

Yes; transactional analysis therapy can be one-on-one, or be attended by couples, families or groups.

How many transactional analysis sessions do I need to have?

This will depend entirely on what you need from therapy. You may wish to agree with your therapist on a fixed number of sessions or enter into an open-ended agreement.

Where are your transactional therapists available?

Transactional analysis is available at our Hove and Lewes practices, as well as online.

What issues can TA help with?

The versatility of TA allows us to use it for a range of difficulties, from everyday communication problems to more troublesome mental health issues.

What is the objective of transactional analysis?

There are many objectives that can be achieved through transaction analysis, but broadly it allows the client to make more informed decisions about the way they choose to behave, and better understand themselves, and those around them.

How can I find the right transactional analysis psychotherapist?

We’ve got a helpful online tool that allows you to get to know more about our psychotherapists, so we’d suggest starting there as a guide to who would be a good fit.

February 16, 2015 by Brighton & Hove Psychotherapy 1 Comment

Top Five Tips for Sleeping to Improve your Psychological Wellbeing

This morning I awoke after an awesome night’s sleep to read an article in The Guardian entitled ‘How Much Sleep Do I Need?‘ This article draws on data from The National Sleep Foundation in the USA who conducted a literature review of 320 research papers into how much sleep (quantity) we should all be getting. The results (unsurprisingly) suggest that adults between 18 and 64 should be getting seven to nine hours for optimal mental and physical health and directly linked a lack of sleep to anxiety and depression. And that is per night, not on average: in other words, we cannot ‘catch up on sleep’, we need to be sleeping the right amount every night. There’s nothing to disagree with here, but the study failed to look at quality of sleep (whether sleep was unbroken), or the architecture of sleep (REM sleep and brain waves).

Last week I wrote a blog on how sleep is integral to good mental health and effective psychotherapy and here is the follow-up listing our top five tips for improving the quantity and quality of your sleep for better mental and emotional health.

Follow your Circadian Rhythms

We humans have evolved under a light-dark cycle (our circadian rhythm) and it has only been with the advent of electricity that this has fundamentally started to change and is increasingly changing. Whilst I am not advocating you move to a cave and live by the light of a fire, there are certain things we can all easily do that will make a difference and reduce our experience of all living with mild jet-lag.

Electronic visual devices emit blue light which has been shown to have a strong detrimental effect on our body clocks (as it slows or stops the production of Melatonin). In nature, blue light is emitted in the morning and then slowly dissipates throughout the day, disappearing at night. By switching off the television, your laptop, tablet computer and smart phone a good hour before bed, you give your body a fighting chance to produce the sleep hormone Melatonin that in turn gives you a good night’s rest.

Additionally, engaging with thrillers on the television, video games on the console, or work emails on your tablet, activates your brain and increases your anxiety levels – the primitive brain does not know the difference between reality and virtual reality, so when we watch an axe murderer chasing an innocent high school kid through a creepy building on the television, our brain responds with increased Cortisol levels (stress hormone) and Adrenaline, just as if we were there is person: we become ready to be chased ourselves. Neither chemical is conducive to sleep and both can leave us feeling anxious and restless.

Calm your Mind

The most effective way to calm the mind (and our emotional system) is through the breath. This is why we at Brighton and Hove Psychotherapy extol the virtues of meditation, or mindfulness in addition to good therapy. A simple practice of spending five to ten minutes before getting into bed focusing on the breath brings us back into our body, calms our mind down and shifts us from the sympathetic to the parasympathetic nervous system – we physically calm right down.

A good routine is to sit in a chair away from distractions and close your eyes. Breathe into your belly (imagine drawing your breath right down to below your belt line) for a count of around 5 seconds, breathing through your nose, pause for a second or two and then gently release all the air through your mouth for a count of 8 to 10 seconds, or whatever you can manage. Find your personal rhythm.

Focus your mind on your breath and body and nothing else. If thoughts pop up (and they will), simply come back to focusing on your breath and noticing if you are tensing your body anywhere and seeing if you can tell that part of your body to relax.

You can time your meditation or breathing exercise with an alarm, starting with five minutes and building up from there (though try not to use the alarm on your smart phone as otherwise you are being exposed to blue light). Evidence shows that meditating for 20 minutes a day can dramatically alter our brains and our ability to manage stress and our emotions.

Stick to a Routine

We humans are creatures of habit. Setting a time to get to bed and sticking to it, can make a real difference. Some researchers have suggested that there is a ‘sweet-spot’ between 10.30pm and 10.45pm when we are ideally primed to get to sleep. Irrespective of whether this is true, researchers do generally agree that it is better to get to bed a little early, than to make up for a late night through sleeping in.

Anecdotal studies have shown that where humans are exposed to only natural light (and camp fires) they naturally feel tired much earlier in the evening and will rise closer to sunrise.

This does not mean you cannot have a late night out, but return to your habit the next night.

Change your Attitude – Sleep is for the strong!

Getting by on little sleep is, amongst some groups (and the late Margaret Thatcher), seen as a sign of strength and fortitude. The reality is though, by ensuring that we get adequate sleep, we give ourselves an edge over those who don’t – mentally and physically and we are significantly more resilient against stress. Plus, we are future proofing our bodies against some chronic illnesses. Eight hours should not be a luxury, it should be a given and evidence you are caring for and about yourself.

Those of us who push ourselves hard and manage our lives with the latest gadgets and gizmos don’t think twice about getting the latest upgraded phone or servicing our performance car so that it does not let us down. Sleep is the human equivalent of an upgrade and a service: our glial cells work through the night to clear away the toxins that have accumulated in the brain during the day. It is therefore a high performance habit!

Remove Stimulants

We all know that caffeine before bed disrupts sleep. But ideally, we should not be eating or drinking very much at all before bed, with the exception of water. Our body and brain needs to partially shut down during sleep, but if your gut is busy digesting a large meal you wolfed down after a late evening in the office, then it is not resting: it is working.

Consider limiting your intake of sugar (including fructose) before bed as this causes an insulin spike and can leave you feeling energised at the wrong time, somewhat anxious and is simply not good for your body – the sugar will be stored as fat.

Drinking alcohol may enable us to feel less socially inhibited, but is also a depressant and raises anxiety levels and stops us entering into a deep sleep state through interrupting our sleep cycle and thus our ability to enter into deeper brain wave states (more on this in a future blog).

In Summary

Find what works for you by getting curious about how best to maximise the potential of your body and mind through sleep. Try avoiding certain drinks and foods and not eating a few hours before bedtime; try picking up an old-fashioned book and heading off to bed in lieu of watching the late news or replying to your boss; try keeping a sleep journal and approach sleep scientifically.

And if all this sounds boring, consider this: Sigmund Freud called dreams the ‘royal road to the unconscious’. By hacking your sleep, you may find that the most exhilarating movie you can watch, is the one playing out in your dreams and that it also gives you an insight into who you are and what you may want and need. As a psychotherapist I consider myself a ‘psychonaut’, meaning that I live to explore my own and your inner world. And it is better than any movie or video game!

By implementing one or all of the above 5 top tips, you will find it easier to both improve the quantity and quality of your sleep. And then you can build on this solid foundation through being able to attend to your psychological and emotional needs with a clear mind and calmer emotional system.

Image Credit: Mark Vahrmeyer

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February 9, 2015 by Brighton & Hove Psychotherapy 2 Comments

Sleep is integral to good mental health and effective psychotherapy

As part of our ever increasing focus on a holistic approach to psychotherapy and mental health (functional psychotherapy) at Brighton and Hove Psychotherapy, I am drawn to writing a little about the importance of sleep and what happens when we don’t get enough. As I have already written, psychotherapy is a fantastic agent of change but an hour of therapy a week is simply not enough to create lasting change.

It is virtually impossible to isolate any one part of a human being and focus on creating health, or balance, in that area without taking into consideration the systemic nature of what it means to be a human being; we are our mind; our body; our brain – and each of these aspects of us is interconnected, so that it is not possible to change one without it impacting on the others. We are embodied beings – our experience of being in the world is of us being in a body, and interacting with the world and ourselves through through and with that body.

A number of articles and studies have recently caught my attention as to how important sleep is to us as human beings. However, most of these articles focus on specific aspects of our physical human experience regarding a lack of sleep – diabetes and obesity (body); the role of neuroscience in sleep – how glial cells clear our neurotoxins from the brain during sleep (brain); or how sleep can contribute to increased levels of anxiety, depression, low self-esteem and can exacerbate the impact of other mood disorders (mind).

Newton’s Third Law states that for every action, there is an opposite and equal reaction. We humans, are part of the physical world and thus bound by the laws of physics. Every thought we have creates a change in our experience of being in the world – physically as well as experientially. Our behaviours shape our thoughts and bodies and vice versa. And our bodies, or rather how we are embodied shapes our thoughts and behaviours. Add into the mix how external stimuli affects all of the above and the variables become enormous.

With the exception of some tribal folk, most of us live in ways that disrupt our circadian rhythms – our natural sleep patterns. The systemic effect of this is enormous, to the extent that scientists suggest that the vast majority of us are living permanently with mild jet-lag. There are physical, emotional and psychological implications to this and, as I have already suggested, they are all three inextricably linked. And yet quality sleep it is one the most influential ways we can radically improve our overall wellbeing – including psychologically.

Why should this matter to psychotherapy, to our clients? Well, effective psychotherapy is about change and psychological and emotional change does not simply happen without work – much like healthy crops don’t just magically start growing in a well-ploughed field. Simple changes to sleep patterns can have a dramatic effect – both short- and long-term – on laying those foundations for getting curious about how we process and carry loss and trauma and improve our psychological and emotional wellbeing.

Without enough sleep, we are running on empty. Our body, brain and mind are simply surviving and crucially, we lose the ability to be a witness to our experience: we become reactive and identify with our emotional experiences, without being able to get curious about them and play with changing the variables such as how our thoughts, behaviours, feelings, bodily sensations and external stimuli all contribute to our experience in that moment. Like crops require a well-ploughed field and adequate water, sunlight and nutrients, the effectiveness of psychotherapy depends on a solid foundation on which to build our sense of self. Psychotherapy certainly helps create this foundation, but quality sleep is one of the core essentials where you can really help yourself out and as such should be considered a daily practice to be mindful of.

So how can we get more sleep? Check out our next blog for our top five sleep tips that will cost you nothing to implement and will make a big difference!

Arrogance of lack of sleep – BBC

Image credit: Mark Vahrmeyer

References:

Neuroscience and clearing the brain of neurotoxins – BBC

Lack of sleep and mental health – NHS

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